Acupuncture Treatment of Dysmenorrhea Resistant to Conventional Medical Treatment

V. Iorno; R. Burani; B. Bianchini; E. Minelli; F. Martinelli; S. Ciatto

Disclosures

Evid Based Complement Alternat Med. 2008;5(2):227-230. 

In This Article

Abstract and Introduction

We evaluated the effect of acupuncture on NSAID resistant dysmenorrhea related pain [measured according to Visual Analogue Scale (VAS)] in 15 consecutive patients. Pain was measured at baseline (T1), mid treatment (T2), end of treatment (T3) and 3 (T4) and 6 months (T5) after the end of treatment. Substantial reduction of pain and NSAID assumption was observed in 13 of 15 patients (87%). Pain intensity was significantly reduced with respect to baseline (average VAS = 8.5), by 64, 72, 60 or 53% at T2, T3, T4 or T5. Greater reduction of pain was observed for primary as compared with secondary dysmenorrhea. Average pain duration at baseline (2.6 days) was significantly reduced by 62, 69, 54 or 54% at T2, T3, T4 or T5. Average NSAID use was significantly reduced by 63, 74, 58 or 58% at T2, T3, T4 or T5, respectively, and ceased totally in 7 patients, still asymptomatic 6 months after treatment. Our findings suggest that acupuncture may be indicated to treat dysmenorrhea related pain, in particular in those subjects in whom NSAID or oral contraceptives are contraindicated or refused.

Dysmenorrhea is a common symptom, reported by ∼25% of women, and by up to 90% of adolescents.[1–4] It has been reported to impair current working activity[5,6] in 10% of cases, as well as quality of life[7] and is the main cause of non-attendance at school for adolescents,[2,3,5,8] and the first cause for adolescents seeking medical advice.[9] Dysmenorrhea is commonly categorized as 'primary´, i.e. in absence of proven pelvic pathology, or 'secondary´, i.e. in presence of pelvic pathology: the distinction has mainly a therapeutic purpose, as for cases of secondary dysmenorrhea (e.g. endometriosis or pelvic inflammatory disease) a specific treatment may be offered.[10] Pain is the dominating symptom, not controlled by NSAID assumption in 20–25% of cases,[11] and several other symptoms, contributing to the pre-menstrual syndrome, may be associated, reaching severe intensity in 3.5–5% of cases.[12]

Non-conventional medicine has become very popular in western countries in recent years.[13,14] Acupuncture, a traditional Chinese medicine procedure, is well tolerated and free of relevant side effects[15] and has been approved by FDA.[16] Acupuncture is commonly used to treat chronic pelvic pain,[17] and its use has been recently recommended by the National Institute of Health for the treatment of several diseases, including dysmenorrhea.

The aim of the present study was to assess the efficacy of acupuncture in a consecutive series of women affected by primary or secondary dysmenorrhea (painful menstrual cramps without or with evident pathology to account for them), not controlled by NSAID. Efficacy was measured in terms of pain control, impact on NSAID consumption, and cost-effectiveness.

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